When our son finally got his first tooth after what felt like months and months of teething, my husband and I were elated. But with every milestone there are questions. I wanted to know not only when I should make his first appointment with a dentist, but also, what are the most important questions to ask the pediatric dentist on that first visit?
The American Academy of Pediatric Dentistry (AAPD) recommends you take your child to the dentist for the first time by age 1, or within six months after they finally get that first tooth. So it looks like we need to start planning that first visit pronto because our son has even more teeth now and he's a year old. Thankfully, we'll be armed with the right questions when that time comes. I asked pediatric dentists what we should ask our own dentist when my son gets his first turn in that chair, and there are some queries on this list that might not occur to first-time parents.
If you're wondering what the difference is between pediatric dentists and "grown-up" dentists (or if there is a difference), the AAPD explains on its website that "a pediatric dentist has two to three years specialty training following dental school and limits his/her practice to treating children only. Pediatric dentists are primary and specialty oral care providers for infants and children through adolescence, including those with special health needs."
Also, pediatric dentists usually have kid-centric distractions in place, like Paw Patrol on the TV and fun sunglasses. (It's all about the distractions.) And they'll definitely be able to answer the following questions.
1. What Toothpaste Should My Child Be Using and How Much?
Pediatric dentist Dr. Ron Baise says this is so important because if you use too much toothpaste, your child could develop a condition called "fluorosis," but if you use too little, then their enamel becomes weakened.
2. Can You Show My Child How To Brush Their Teeth?
Baise tells Romper that "Brushing your own teeth and teaching someone else how to brush their teeth are very different skills. Pediatric dentists and hygienists are very well practiced in this and can therefore teach children how to brush their teeth more effectively than parents can."
3. When Is A Normal Time For My Child's Baby Teeth To Come Out?
"Different children's teeth come out at different times. However if your child still has baby teeth after age 9 then its worth getting an x-ray to see if adult teeth are present underneath the gums," Baise says. "In very rare cases, children only have one set of certain teeth, and therefore baby teeth will not come out."
4. When Should My Child Start Flossing?
"Flossing is only effective when there are no visible gaps between children’s teeth," Baise says. "This occurs at a different time for children, so it's worth asking a pediatric dentist when your child should start to floss."
5. What Are Alternatives To Flossing?
Many children (and adults, let's face it) have a hard time flossing. Whether it's time or the hassle of trying to get back to your molars. Baise says to ask your dentist about their recommended alternatives. He recommends water piks and interdental brushes.
6. Is My Child's Thumb Sucking/Use Of A Pacifier A Problem?
As we've all heard before, thumbsucking and pacifier use can potentially lead to crooked teeth. Baise says, "The extent of the problem can be assessed by a dentist, so if you want to put your mind at ease over your child's thumbsucking its worth asking them if they feel that it has caused any noticeable effect."
7. When Do They Start Taking Dental X-Rays?
"Often x-rays aren't taken until age 5 unless there is a cavity or trauma," Dr. David Zirlin, a pediatric dentist at White Plains and Larchmont Pediatric Dentistry tells Romper.
"X-rays help visualize parts of the teeth that can't be seen clinically. When the patient is older, x-rays that are taken also monitor normal dental development and aid in the diagnosis of the appropriate timing to be evaluated by an orthodontist. However, that is usually not until age 7 as recommended by the American Association of Orthodontists."
8. When Should We Start Using A Fluoride Toothpaste?
"For children under the age of 3 only a rice sized/smear of toothpaste amount is advised. The amount of fluoride in young children is limited to minimize ingestion. Too much ingested fluoride may cause dental fluorosis, a mottled appearance to the adult enamel," Zirlin explains.
9. When Should We Start Using A Fluoride Mouthwash?
"Fluoride mouthwash helps to protect the part of the teeth that may be difficult to clean with the bristles of the toothbrush alone," Zirlin says. "Some children have crowded overlapping teeth or wear orthodontic appliances/braces."
"Fluoride mouthwash is recommended for children that are able to rinse and spit — which is usually around ages 5 to 6. This is later than when children start using fluoride toothpaste."
10. What Do I Do If My Child Has "Shark Teeth"?
Zirlin says "Shark Teeth" is the term used when the adult teeth grow in before the baby teeth fall out: "Sometimes the roots of baby teeth do not dissolve or the position of the newly erupting adult tooth isn't directly underneath the baby tooth it is supposed to replace."
"Once the over-retained baby tooth is lost/removed, the position of the adult tooth is evaluated. Often no treatment is needed and the adult tooth settles into the correct position. However, sometimes orthodontic intervention is needed to correct it's position. This can be done with braces, or a removable appliance/retainer," he says.
11. Do You Notice Any Brushing Blind Spots?
"People fall into habits when brushing their teeth, often missing certain areas of their mouth when brushing," Baise says. "This can be detected by a dentist, so it's worth asking whether your child has any of these 'blind spots' and then they can adjust their brushing accordingly."
12. Does My Child Have Enough Space In Their Mouth For Adult Teeth?
Baise says the main cause of crooked adult teeth is overcrowding due to a lack of space in the mouth. "This can usually be anticipated before the adult teeth fully come through. If a lack of space is anticipated, a palate expander can reduce the need for expensive orthodontic treatment down the line."
13. What Do I Do If My Child Has A Chipped Tooth?
"If a child has a chipped tooth, a visit is advised to evaluate the severity of the 'chip' or fracture," Zirlin says. "Sometimes the rough edge needs to be filed or smoothed, it may need to be repaired or bonded, and sometimes no treatment is needed."
Zirlin adds, "If it is a large fracture and the nerve is exposed, the tooth may need to be removed. Some teeth fall out or exfoliate between ages 5 and 6 while others not until ages 12 to 14. The treatment depends on the type of tooth (molar versus incisor, and baby versus adult), the age of the patient, and the severity/depth of the chip."
14. Does My Child Have A Tongue Or Lip Tie?
An untreated tongue or lip tie can affect how your child eats, speaks, and swallows, according to The Mayo Clinic. If your child hadn't been evaluated already if you were breastfeeding, then it's super important to check now.
Dr. Ron Baise, pediatric dentist at 92 Dental
Dr. David Zirlin, pediatric dentist at White Plains and Larchmont Pediatric Dentistry